P3439 - Impact of Elective Cholecystectomy Following ERCP on Readmission Rate in Pregnant Patients With Choledocholithiasis: A Nationwide Analysis

Award: Presidential Poster Award

Fnu Faheela, MBBS¹, Maham Waqar, MD², Muhammad Haseeb, MD, MSc³, Aamir Saeed, MD⁴, Muhammad Kamal, MD⁵, Sandesh Parajuli, MD⁶, Zubair Khan, MD⁷, Sultan Mahmood, MD^8
1Nishtar Medical University, Multan, Punjab, Pakistan; ²Allegheny General Hospital, Pittsburgh, PA; ³University of Pittsburgh Medical Center, Pittsburgh, PA; ⁴Vanderbilt University Medical Center, Nashville, TN; ⁵Hackensack Meridian Health, Roselle Park, NJ; ⁶Reading Hospital - Tower Health, Reading, PA; ⁷Mercy Hospital Jefferson, Festus, MO; ⁸University of Pittsburgh Medical Center, Wexford, PA

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) followed by elective laparoscopic cholecystectomy (CCY) during admission for choledocholithiasis is recommended and considered safe during pregnancy to provide definitive treatment and reduce the risk of recurrent biliary events. However, it is unclear whether it has an impact on preventing the risk of readmission compared to ERCP alone. Our study aimed to evaluate the impact of either of these approaches on the readmission rate in pregnant patients hospitalized with choledocholithiasis in the US.

Methods: The National Readmission Database (NRD) for 2021 was queried using ICD-10-CM Codes to identify a cohort of pregnant female patients who underwent ERCP or ERCP with CCY as the primary indication for choledocholithiasis. A weighted sample was used to obtain baseline characteristics and 30-day readmission rates. Univariate and multivariate logistic regression analyses were used to analyze the unadjusted and adjusted odds ratios for readmission

Results: Among the 1419 pregnant patients admitted with choledocholithiasis, 442 (31.1%) underwent ERCP only, compared to 977(68.9%) who underwent elective CCY following ERCP during the same admission. Baseline characteristics, including age and comorbidities, were comparable between the two groups. Our cohort was broadly admitted to a large urban teaching hospital. Compared to patients with only ERCP, there was a larger proportion of patients with private insurance who underwent CCY during the same admission period (35% vs. 48%). The 30-day all-cause readmission rate was higher in the ERCP group than in the ERCP and Cholecystectomy groups (11% vs. 1.8%). The adjusted Odds of readmission for ERCP and Cholecystectomy group were 0.16 times lower (95% CI 0.16 – 0.33) than those with only ERCP. The top five diagnoses for readmission did not include any diagnoses related to postsurgical complications.

Discussion: Our study shows that elective CCY following ERCP is safe and associated with a decreased risk of 30-day readmission compared to ERCP alone in pregnant patients for choledocholithiasis.



Disclosures:


Fnu Faheela, MBBS¹, Maham Waqar, MD², Muhammad Haseeb, MD, MSc³, Aamir Saeed, MD⁴, Muhammad Kamal, MD⁵, Sandesh Parajuli, MD⁶, Zubair Khan, MD⁷, Sultan Mahmood, MD⁸. P3439 - Impact of Elective Cholecystectomy Following ERCP on Readmission Rate in Pregnant Patients With Choledocholithiasis: A Nationwide Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.